Harabuchi Y, Faden H, Yamanaka N, Duffy L, Wolf J, Krystofik D
Department of Otolaryngology, Sapporo Medical College, Japan.
J Infect Dis. 1994 Oct;170(4):862-6. doi: 10.1093/infdis/170.4.862.
The relationship between nasopharyngeal colonization with nontypeable H. influenzae and recurrent otitis media was assessed in 157 children followed prospectively from birth through 12 months of age. Forty-nine (31%) became colonized. Nasopharyngeal secretory IgA (sIgA) reactive with the P6 outer membrane protein was detected in all colonized children. Reduction or elimination of the organism was associated with a better mucosal immune response (560 +/- 864 units/ng/mL of sIgA) than was persistence in the nasopharynx (121 +/- 81; P = .04). Forty colonized children (82%) and 61 noncolonized children (56%) developed otitis media (P = .004); colonized children were four times more likely to be classified as otitis prone (P = .003). The frequency of otitis media episodes was directly related to the frequency of colonization (r = .42, P < .01). These results demonstrate a strong relationship between nasopharyngeal colonization patterns and otitis media. The mucosal immune response may be important in elimination of potential pathogens from the respiratory tract.
对157名从出生到12个月大进行前瞻性随访的儿童，评估了不可分型流感嗜血杆菌鼻咽定植与复发性中耳炎之间的关系。49名（31%）儿童发生了定植。在所有定植儿童中均检测到与P6外膜蛋白反应的鼻咽分泌型IgA（sIgA）。病原体减少或清除与比在鼻咽部持续存在时更好的黏膜免疫反应（sIgA为560±864单位/纳克/毫升）相关（121±81；P = 0.04）。40名定植儿童（82%）和61名未定植儿童（56%）发生了中耳炎（P = 0.004）；定植儿童被归类为易患中耳炎的可能性高出四倍（P = 0.003）。中耳炎发作频率与定植频率直接相关（r = 0.42，P < 0.01）。这些结果表明鼻咽定植模式与中耳炎之间存在密切关系。黏膜免疫反应对于从呼吸道清除潜在病原体可能很重要。
